PANORAMA’S recent documentary on how different nations tried containing Covid-19 told, in a few minutes, how the Indian state of Kerala responded.

These few minutes of television also made very clear why so many died in Britain.

I’d thoroughly recommend watching Panorama’s documentary, Covid: Who Got it Right, because it underlines how Britain’s response contained so many weird, unusual Thatcherite programmes, which break with very basic public health messages.

But the contrast with Kerala is particularly shaming for the government.

Kerala is a state in the south-west of India with 35 million inhabitants. 

It’s much  poorer than Britain, with a GDP per inhabitant of around $3,200 (£2,330) compared with $39,000 (£28,500) in the UK. 

We are 10 times richer, but Kerala has had under 5,000 Covid-19 deaths, compared with our 126,000.

The reason is simple: Kerala takes public health seriously, and treats it with human activity. Britain doesn’t, and treats it with contracts.

India as a whole introduced community health workers, called accredited social health activists (ASHAs) in 2005.  

Kerala, which has a communist government that is even more focused on public health than India as a whole, made good use of these ASHAs. 

Kerala was particularly exposed to international pandemics, because may Keralans work abroad, especially in the Gulf states. 

Facing the pandemic, health minister KK Shailaja launched the Break the Chain programme. 

This included imaginative public hygiene campaigns, promoting handwashing with entertaining videos of dancing soldiers and handing out umbrellas to encourage social distancing, to show people not to stand too close. 

Crucially Shailaja created a strict 14-day isolation regime for returnees from abroad, Covid-19 sufferers and contacts. 

Kerala’s 30,000 or so ASHAs play a key role. They visit everyone who is isolating for Covid-19, knocking on the door to ask how they are getting on, and if necessary delivering them groceries or cooked food from community kitchens. 

The ASHAs typically visit around 30 houses a day, travelling around on scooters or by foot. 

They give those self-isolating their phone numbers to keep in touch. 

Kerala, unsurprisingly, has a very high compliance with self-isolation, and while it has wrestled with different Covid-19 waves and outbreaks, is a model of public health.

Britain is not. We test millions of people and tell them to self-isolate, but compliance is as low as 11 per cent. 

Kerala does it with physical visits by public health officials. We do it by a contract with a call centre.

The government paid two private firms, Serco and Sitel, £720 million to do what the ASHAs of Kerala do. 

The ASHAs are lauded around the world as the “corona warriors of Kerala” for their doorstep work. 

Serco’s phone-only scheme is a byword for failure. When the Serco staff were hired the job ads said: “No medical knowledge is required and the work is heavily scripted.”

I have copies of these scripts. They show why compliance is so low. They give out generic instructions to “self-isolate at home for 14 days from the day you were in contact with the case” and bald, untailored orders to “not got to work, school, or public areas.”

But what if people need help with money or shopping? The scripts do have a box on what to do if the “contact requires support while self-isolating.” But it offers little help.

If contacts ask: “How do I get food?” 

The scripts say: “You will need to ask friends or relatives if you require help with buying groceries, other shopping or picking up medication. Alternatively, you can order by phone or online.”

If contacts say: “I am unable to access online shopping, what do I do?”

The response is: “If you do not have anyone who can help you to get the things you need for your stay at home, you should contact your local authority as they may be able to help.”

So instead of funding local authorities to visit self-isolators, the government paid a call centre to advise them to contact local authorities.

If contacts say: “I need to work, I can’t afford to stay at home.”

The call centre will then advise: “If you need to stay at home; you will be eligible for statutory sick pay (SSP) from the first day of your absence from work.”

But SSP is just £95.85. If you people can’t feed their family, they won’t self-isolate.

The scripts also advise call handlers to say: “If you are on a low income you may be able to receive the NHS Test and Trace Self-Isolation Payment from your local authority while you self-isolate.”

These payments are very hard to get, and only available to people on benefits. And in any case, the Serco staff can’t really help. 

The scripts say: “You can contact your local authority to find out whether the scheme is available in your area and whether you would be eligible.” 

So again, the privatised call centre just pushes the big questions back to local authorities. 

The Covid-19 call centre really only offers advice, rather than actual help. And even the advice is bizarrely limited.

“What should I do if the case or contact requests an email with the advice I have provided today?” asks the call centre crib sheet.

“The programme does not send out emails to the cases and contacts with advice” is the bald answer.

Serco’s call centre has difficulty reaching contacts: one big clue why is in the scripts. 

“Agents” are told if they leave answerphone messages, they must say: “You will be contacted again later today or tomorrow” because “this number is outbound only.” 

Nobody contacted by the call centre can ring them back. Compare this to Kerala’s personal doorstep visits from ASHAs who willingly hand over their phone contact details.

The government handed the contract to Serco and Sitel for contact tracing because they did not want to build up social, health or welfare services — they wanted to hand contracts to their mates. 

Instead of a public health system, it created the equivalent of a nuisance call. 

They tried to replace public health with cold calling techniques borrowed from marketing, and failed. 

We might be 10 times richer than Kerala, but what they did was 10 times more effective, with 10 times fewer people dying as a result.